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The use of Tablo continuous veno-venous haemodialysis to rapidly remove lithium in a patient with severe lithium toxicity
  1. Brian Nohomovich,
  2. Emmanuel Tito,
  3. Michael Terrio and
  4. Matthew Belardo
  1. Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
  1. Correspondence to Dr Brian Nohomovich; bnohomovich{at}


We report a case of severe, life-threatening lithium toxicity in a patient with bipolar I disorder who presented with altered mental status and acute renal failure. At admission, serum lithium level was well above toxic levels (>2 mEq/L). The signs and symptoms of lithium toxicity significantly improved after treatment with continuous veno-venous haemodialysis (CVVHD). The patient was discharged with no neurological or renal sequelae. Herein is the first case report using the Tablo CVVHD system to treat severe lithium toxicity.

  • Dialysis
  • Toxicology
  • Mood disorders (including depression)

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  • Contributors BN is the lead author and is responsible for the design of the case report, planning, drafting, and writing of the case, research, and final editing. ET was part of the team that oversaw the patient, conducted research on lithium toxicity treatment and drafted the sections regarding lithium toxicity. He also directly edited the overall final draft. MT directly researched the lithium toxicity mechanism in the discussion. He drafted that part of the manuscript and participated in the final editing process. MB directly oversaw the patient, drafted the learning points, and participated in editing the overall document and final edits. All authors participated in the final editing and agree to assume responsibility for the accuracy of this document.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.